Morphology of the patent ductus arteriosus; A predictor of the outcome of Stenting in Duct-Dependent Pulmonary Circulation; An Experience in Children Hospital, Cairo University

  • Hala Hala Agha, Children Hospital, Cairo University, Egypt
  • Hala Hala Hamza, Children Hospital, Cairo University, Egypt
  • N Sreeram, Cologne university, Germany
  • Konrad K Brockmeier, Cologne university, Germany
  • Yasser y Hussein, Children Hospital, Cairo University, Egypt
  • Amira A Esmat, Children Hospital, Cairo University, Egypt

    • Objectives: To present an institutional experience with stent placement in patent ductus arteriosus (PDA) in the neonates and infants with duct-dependent pulmonary circulation and to assess the outcome of the procedure.

    Background: PDA has been proposed as an alternative to surgical shunt on account of postoperative complications of surgical shunting.

    Methods: Twelve patients with duct -dependent pulmonary circulation who were sent to the cardiac catheterization laboratory for percutaneous ductal stenting from April 2008 to November 2008 constitute the study population. Six patients did not qualify because of complex tortuous ductus arteriosus or branch pulmonary artery stenosis. Atrial septostomy by balloon dilatation was performed as required.

    Results: The mean age of the patients at the time of stent implantation was 34± 16days. The mean body weight was 4 ± 1Kg. Ductal stenting was successful in 6 patients; four of them had straight horizontal duct, while the other two patients had a vertical duct. The mean ductal diameter was 3.6 ± 0.2 mm. Balloon-expandable coronary stents of 4mm in diameter and 5mm longer than the PDA length were used. The duration of hospital stay was 5.83±6.4days. The mean duration of follow-up was 4.75months and mean oxygen saturation at last follow-up was 85.2 ± 15.5%. The cumulative mortality was 2/6 (33.3%).

    Conclusions: Stenting the PDA in selected patients is effective for short-term palliation in infants with duct-dependant pulmonary circulation. Morphology of the PDA predicts the outcome of this procedure. Stent should be longer than the ductus length to avoid its constriction.